Toward Evaluation of Disseminated Effects of Medications for Opioid Use Disorder within Provider-Based Clusters Using Routinely-Collected Health Data

Authors

Ashley L. Buchanan, University of Rhode IslandFollow
Sun, University of Rhode Island
Jing Wu, University of Rhode IslandFollow
Hilary Aroke, University of Rhode Island
Jeffrey P. Bratberg, University of Rhode IslandFollow
Josiah Rich
Stephen Jon Kogut, University of Rhode IslandFollow
Joseph Hogan

Document Type

Article

Date of Original Version

2022

Abstract

Routinely-collected health data can be employed to emulate a target trial when randomized trial data are not available. Patients within provider-based clusters likely exert and share influence on each other’s treatment preferences and subsequent health outcomes and this is known as dissemination or spillover. Extending a framework to replicate an idealized two-stage randomized trial using routinely-collected health data, an evaluation of disseminated effects within provider-based clusters is possible. In this paper, we propose a novel application of causal inference methods for dissemination to retrospective cohort studies in administrative claims data and evaluate the impact of the normality of the random effects distribution for the cluster-level propensity score on estimation of the causal parameters. An extensive simulation study was conducted to study the robustness of the methods under different distributions of the random effects. We applied these methods to evaluate baseline prescription for medications for opioid use disorder among a cohort of patients diagnosed opioid use disorder and adjust for baseline confounders using information obtained from an administrative claims database. We discuss future research directions in this setting to better address unmeasured confounding in the presence of disseminated effects.

Publication Title, e.g., Journal

medRxiv

Citation/Publisher Attribution

Buchanan, A. L., Sun, T., Wu, J., Aroke, H., Bratberg, J., Rich, J.,... & Hogan, J. (2022). Toward Evaluation of Disseminated Effects of Medications for Opioid Use Disorder within Provider-Based Clusters Using Routinely-Collected Health Data. medRxiv. In press. https://doi.org/10.1101/2022.04.15.22273847

Available at: https://doi.org/10.1101/2022.04.15.22273847

Creative Commons License

This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.

Comment

Ashley Buchanan, Jeffrey Bratberg and Stephen Kogut are from the Department of Pharmacy Practice.

Jing Wu is from the Department of Computer Science and Statistics.